|
ED Orthopedic Cast Application: Foot/Ankle
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
9220238
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$319.00
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$52.20
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$80.76
|
| Rate for Payer: BCBS of TX Blue Essentials |
$96.72
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$121.87
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$39.03
|
| Rate for Payer: Cigna Medicare |
$245.61
|
| Rate for Payer: Employer Direct Commercial |
$245.61
|
| Rate for Payer: Humana Medicare/TRICARE |
$245.61
|
| Rate for Payer: Molina CHIP/Medicaid |
$39.03
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$377.00
|
| Rate for Payer: Multiplan Commercial |
$377.00
|
| Rate for Payer: Multiplan Workers Comp |
$377.00
|
| Rate for Payer: Parkland Medicaid |
$39.03
|
| Rate for Payer: Scott and White EPO/PPO |
$4.39
|
| Rate for Payer: Scott and White Medicare |
$245.61
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$39.03
|
| Rate for Payer: Superior Health Plan EPO |
$245.61
|
| Rate for Payer: Superior Health Plan Medicare |
$245.61
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Universal American Medicare |
$245.61
|
| Rate for Payer: Wellcare Medicare |
$245.61
|
| Rate for Payer: Wellmed Medicare |
$245.61
|
|
|
ED Orthopedic Cast Application Foot/Ankle BCE
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
9220238
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$319.00
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$52.20
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$80.76
|
| Rate for Payer: BCBS of TX Blue Essentials |
$96.72
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$121.87
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$39.03
|
| Rate for Payer: Cigna Medicare |
$245.61
|
| Rate for Payer: Employer Direct Commercial |
$245.61
|
| Rate for Payer: Humana Medicare/TRICARE |
$245.61
|
| Rate for Payer: Molina CHIP/Medicaid |
$39.03
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$377.00
|
| Rate for Payer: Multiplan Commercial |
$377.00
|
| Rate for Payer: Multiplan Workers Comp |
$377.00
|
| Rate for Payer: Parkland Medicaid |
$39.03
|
| Rate for Payer: Scott and White EPO/PPO |
$4.39
|
| Rate for Payer: Scott and White Medicare |
$245.61
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$39.03
|
| Rate for Payer: Superior Health Plan EPO |
$245.61
|
| Rate for Payer: Superior Health Plan Medicare |
$245.61
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Universal American Medicare |
$245.61
|
| Rate for Payer: Wellcare Medicare |
$245.61
|
| Rate for Payer: Wellmed Medicare |
$245.61
|
|
|
ED Orthopedic Cast Application Foot/Ankle BCE
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
9220238
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$510.40
|
|
|
ED Orthopedic Cast Application: Forearm
|
Facility
|
OP
|
$520.00
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
9220231
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$286.00
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$46.80
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$92.22
|
| Rate for Payer: BCBS of TX Blue Essentials |
$110.44
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$139.15
|
| Rate for Payer: Cash Price |
$457.60
|
| Rate for Payer: Cash Price |
$457.60
|
| Rate for Payer: Cash Price |
$457.60
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$45.13
|
| Rate for Payer: Cigna Medicare |
$245.61
|
| Rate for Payer: Employer Direct Commercial |
$245.61
|
| Rate for Payer: Humana Medicare/TRICARE |
$245.61
|
| Rate for Payer: Molina CHIP/Medicaid |
$45.13
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$338.00
|
| Rate for Payer: Multiplan Commercial |
$338.00
|
| Rate for Payer: Multiplan Workers Comp |
$338.00
|
| Rate for Payer: Parkland Medicaid |
$45.13
|
| Rate for Payer: Scott and White EPO/PPO |
$4.39
|
| Rate for Payer: Scott and White Medicare |
$245.61
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$45.13
|
| Rate for Payer: Superior Health Plan EPO |
$245.61
|
| Rate for Payer: Superior Health Plan Medicare |
$245.61
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Universal American Medicare |
$245.61
|
| Rate for Payer: Wellcare Medicare |
$245.61
|
| Rate for Payer: Wellmed Medicare |
$245.61
|
|
|
ED Orthopedic Cast Application Forearm BCE
|
Facility
|
OP
|
$520.00
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
9220231
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$286.00
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$46.80
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$92.22
|
| Rate for Payer: BCBS of TX Blue Essentials |
$110.44
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$139.15
|
| Rate for Payer: Cash Price |
$457.60
|
| Rate for Payer: Cash Price |
$457.60
|
| Rate for Payer: Cash Price |
$457.60
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$45.13
|
| Rate for Payer: Cigna Medicare |
$245.61
|
| Rate for Payer: Employer Direct Commercial |
$245.61
|
| Rate for Payer: Humana Medicare/TRICARE |
$245.61
|
| Rate for Payer: Molina CHIP/Medicaid |
$45.13
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$338.00
|
| Rate for Payer: Multiplan Commercial |
$338.00
|
| Rate for Payer: Multiplan Workers Comp |
$338.00
|
| Rate for Payer: Parkland Medicaid |
$45.13
|
| Rate for Payer: Scott and White EPO/PPO |
$4.39
|
| Rate for Payer: Scott and White Medicare |
$245.61
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$45.13
|
| Rate for Payer: Superior Health Plan EPO |
$245.61
|
| Rate for Payer: Superior Health Plan Medicare |
$245.61
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Universal American Medicare |
$245.61
|
| Rate for Payer: Wellcare Medicare |
$245.61
|
| Rate for Payer: Wellmed Medicare |
$245.61
|
|
|
ED Orthopedic Cast Application Forearm BCE
|
Facility
|
IP
|
$520.00
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
9220231
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$457.60
|
|
|
ED Orthopedic Cast Application: Hand
|
Facility
|
OP
|
$745.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
9220210
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$488.55 |
| Rate for Payer: Aetna Commercial |
$409.75
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$67.05
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Amerigroup Medicare |
$215.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$181.96
|
| Rate for Payer: BCBS of TX Blue Essentials |
$217.92
|
| Rate for Payer: BCBS of TX Medicare |
$215.67
|
| Rate for Payer: BCBS of TX PPO |
$274.58
|
| Rate for Payer: Cash Price |
$655.60
|
| Rate for Payer: Cash Price |
$655.60
|
| Rate for Payer: Cash Price |
$655.60
|
| Rate for Payer: Cigna Commercial |
$488.55
|
| Rate for Payer: Cigna Medicaid |
$85.32
|
| Rate for Payer: Cigna Medicare |
$215.67
|
| Rate for Payer: Employer Direct Commercial |
$215.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$215.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$85.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Molina Medicare |
$215.67
|
| Rate for Payer: Multiplan Auto |
$484.25
|
| Rate for Payer: Multiplan Commercial |
$484.25
|
| Rate for Payer: Multiplan Workers Comp |
$484.25
|
| Rate for Payer: Parkland Medicaid |
$85.32
|
| Rate for Payer: Scott and White EPO/PPO |
$3.86
|
| Rate for Payer: Scott and White Medicare |
$215.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$85.32
|
| Rate for Payer: Superior Health Plan EPO |
$215.67
|
| Rate for Payer: Superior Health Plan Medicare |
$215.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Universal American Medicare |
$215.67
|
| Rate for Payer: Wellcare Medicare |
$215.67
|
| Rate for Payer: Wellmed Medicare |
$215.67
|
|
|
ED Orthopedic Cast Application: Hand
|
Facility
|
IP
|
$745.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
9220210
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$655.60
|
|
|
ED Orthopedic Cast Application Hand BCE
|
Facility
|
OP
|
$682.00
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
9220210
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$443.30 |
| Rate for Payer: Aetna Commercial |
$375.10
|
| Rate for Payer: Aetna Medicare |
$216.15
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$61.38
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Amerigroup Medicare |
$144.10
|
| Rate for Payer: BCBS of TX Blue Advantage |
$100.05
|
| Rate for Payer: BCBS of TX Blue Essentials |
$119.82
|
| Rate for Payer: BCBS of TX Medicare |
$144.10
|
| Rate for Payer: BCBS of TX PPO |
$150.97
|
| Rate for Payer: Cash Price |
$600.16
|
| Rate for Payer: Cash Price |
$600.16
|
| Rate for Payer: Cash Price |
$600.16
|
| Rate for Payer: Cigna Commercial |
$326.44
|
| Rate for Payer: Cigna Medicaid |
$48.73
|
| Rate for Payer: Cigna Medicare |
$144.10
|
| Rate for Payer: Employer Direct Commercial |
$144.10
|
| Rate for Payer: Humana Medicare/TRICARE |
$144.10
|
| Rate for Payer: Molina CHIP/Medicaid |
$48.73
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Molina Medicare |
$144.10
|
| Rate for Payer: Multiplan Auto |
$443.30
|
| Rate for Payer: Multiplan Commercial |
$443.30
|
| Rate for Payer: Multiplan Workers Comp |
$443.30
|
| Rate for Payer: Parkland Medicaid |
$48.73
|
| Rate for Payer: Scott and White EPO/PPO |
$2.58
|
| Rate for Payer: Scott and White Medicare |
$144.10
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$48.73
|
| Rate for Payer: Superior Health Plan EPO |
$144.10
|
| Rate for Payer: Superior Health Plan Medicare |
$144.10
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Universal American Medicare |
$144.10
|
| Rate for Payer: Wellcare Medicare |
$144.10
|
| Rate for Payer: Wellmed Medicare |
$144.10
|
|
|
ED Orthopedic Cast Application Hand BCE
|
Facility
|
IP
|
$682.00
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
9220210
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$600.16
|
|
|
ED Orthopedic Cast Application: Lower Extremity
|
Facility
|
OP
|
$741.00
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
9220235
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$407.55
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$66.69
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$131.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$157.36
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$198.27
|
| Rate for Payer: Cash Price |
$652.08
|
| Rate for Payer: Cash Price |
$652.08
|
| Rate for Payer: Cash Price |
$652.08
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$63.67
|
| Rate for Payer: Cigna Medicare |
$245.61
|
| Rate for Payer: Employer Direct Commercial |
$245.61
|
| Rate for Payer: Humana Medicare/TRICARE |
$245.61
|
| Rate for Payer: Molina CHIP/Medicaid |
$63.67
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$481.65
|
| Rate for Payer: Multiplan Commercial |
$481.65
|
| Rate for Payer: Multiplan Workers Comp |
$481.65
|
| Rate for Payer: Parkland Medicaid |
$63.67
|
| Rate for Payer: Scott and White EPO/PPO |
$4.39
|
| Rate for Payer: Scott and White Medicare |
$245.61
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$63.67
|
| Rate for Payer: Superior Health Plan EPO |
$245.61
|
| Rate for Payer: Superior Health Plan Medicare |
$245.61
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Universal American Medicare |
$245.61
|
| Rate for Payer: Wellcare Medicare |
$245.61
|
| Rate for Payer: Wellmed Medicare |
$245.61
|
|
|
ED Orthopedic Cast Application Lower Extremity BCE
|
Facility
|
IP
|
$741.00
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
9220235
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$652.08
|
|
|
ED Orthopedic Cast Application Lower Extremity BCE
|
Facility
|
OP
|
$741.00
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
9220235
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$407.55
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$66.69
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$131.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$157.36
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$198.27
|
| Rate for Payer: Cash Price |
$652.08
|
| Rate for Payer: Cash Price |
$652.08
|
| Rate for Payer: Cash Price |
$652.08
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$63.67
|
| Rate for Payer: Cigna Medicare |
$245.61
|
| Rate for Payer: Employer Direct Commercial |
$245.61
|
| Rate for Payer: Humana Medicare/TRICARE |
$245.61
|
| Rate for Payer: Molina CHIP/Medicaid |
$63.67
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$481.65
|
| Rate for Payer: Multiplan Commercial |
$481.65
|
| Rate for Payer: Multiplan Workers Comp |
$481.65
|
| Rate for Payer: Parkland Medicaid |
$63.67
|
| Rate for Payer: Scott and White EPO/PPO |
$4.39
|
| Rate for Payer: Scott and White Medicare |
$245.61
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$63.67
|
| Rate for Payer: Superior Health Plan EPO |
$245.61
|
| Rate for Payer: Superior Health Plan Medicare |
$245.61
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Universal American Medicare |
$245.61
|
| Rate for Payer: Wellcare Medicare |
$245.61
|
| Rate for Payer: Wellmed Medicare |
$245.61
|
|
|
ED Orthopedic Cast Application: Upper Arm/Elbow
|
Facility
|
OP
|
$682.00
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
9220230
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$443.30 |
| Rate for Payer: Aetna Commercial |
$375.10
|
| Rate for Payer: Aetna Medicare |
$216.15
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$61.38
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Amerigroup Medicare |
$144.10
|
| Rate for Payer: BCBS of TX Blue Advantage |
$100.05
|
| Rate for Payer: BCBS of TX Blue Essentials |
$119.82
|
| Rate for Payer: BCBS of TX Medicare |
$144.10
|
| Rate for Payer: BCBS of TX PPO |
$150.97
|
| Rate for Payer: Cash Price |
$600.16
|
| Rate for Payer: Cash Price |
$600.16
|
| Rate for Payer: Cash Price |
$600.16
|
| Rate for Payer: Cigna Commercial |
$326.44
|
| Rate for Payer: Cigna Medicaid |
$48.73
|
| Rate for Payer: Cigna Medicare |
$144.10
|
| Rate for Payer: Employer Direct Commercial |
$144.10
|
| Rate for Payer: Humana Medicare/TRICARE |
$144.10
|
| Rate for Payer: Molina CHIP/Medicaid |
$48.73
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Molina Medicare |
$144.10
|
| Rate for Payer: Multiplan Auto |
$443.30
|
| Rate for Payer: Multiplan Commercial |
$443.30
|
| Rate for Payer: Multiplan Workers Comp |
$443.30
|
| Rate for Payer: Parkland Medicaid |
$48.73
|
| Rate for Payer: Scott and White EPO/PPO |
$2.58
|
| Rate for Payer: Scott and White Medicare |
$144.10
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$48.73
|
| Rate for Payer: Superior Health Plan EPO |
$144.10
|
| Rate for Payer: Superior Health Plan Medicare |
$144.10
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Universal American Medicare |
$144.10
|
| Rate for Payer: Wellcare Medicare |
$144.10
|
| Rate for Payer: Wellmed Medicare |
$144.10
|
|
|
ED Orthopedic Cast Application: Upper Arm/Elbow
|
Facility
|
IP
|
$682.00
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
9220230
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$600.16
|
|
|
ED Orthopedic Cast Application Upper Arm/Elbow BCE
|
Facility
|
OP
|
$544.00
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
9220230
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$299.20
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$48.96
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$100.65
|
| Rate for Payer: BCBS of TX Blue Essentials |
$120.54
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$151.88
|
| Rate for Payer: Cash Price |
$478.72
|
| Rate for Payer: Cash Price |
$478.72
|
| Rate for Payer: Cash Price |
$478.72
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$49.28
|
| Rate for Payer: Cigna Medicare |
$245.61
|
| Rate for Payer: Employer Direct Commercial |
$245.61
|
| Rate for Payer: Humana Medicare/TRICARE |
$245.61
|
| Rate for Payer: Molina CHIP/Medicaid |
$49.28
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$353.60
|
| Rate for Payer: Multiplan Commercial |
$353.60
|
| Rate for Payer: Multiplan Workers Comp |
$353.60
|
| Rate for Payer: Parkland Medicaid |
$49.28
|
| Rate for Payer: Scott and White EPO/PPO |
$4.39
|
| Rate for Payer: Scott and White Medicare |
$245.61
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$49.28
|
| Rate for Payer: Superior Health Plan EPO |
$245.61
|
| Rate for Payer: Superior Health Plan Medicare |
$245.61
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Universal American Medicare |
$245.61
|
| Rate for Payer: Wellcare Medicare |
$245.61
|
| Rate for Payer: Wellmed Medicare |
$245.61
|
|
|
ED Orthopedic Cast Application Upper Arm/Elbow BCE
|
Facility
|
IP
|
$544.00
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
9220230
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$478.72
|
|
|
ED Orthopedic Cast Removal: Arm/Leg
|
Facility
|
OP
|
$644.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
5202579
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$354.20
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$57.96
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$57.26
|
| Rate for Payer: BCBS of TX Blue Essentials |
$68.58
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$86.41
|
| Rate for Payer: Cash Price |
$566.72
|
| Rate for Payer: Cash Price |
$566.72
|
| Rate for Payer: Cash Price |
$566.72
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$27.13
|
| Rate for Payer: Cigna Medicare |
$245.61
|
| Rate for Payer: Employer Direct Commercial |
$245.61
|
| Rate for Payer: Humana Medicare/TRICARE |
$245.61
|
| Rate for Payer: Molina CHIP/Medicaid |
$27.13
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$418.60
|
| Rate for Payer: Multiplan Commercial |
$418.60
|
| Rate for Payer: Multiplan Workers Comp |
$418.60
|
| Rate for Payer: Parkland Medicaid |
$27.13
|
| Rate for Payer: Scott and White EPO/PPO |
$4.39
|
| Rate for Payer: Scott and White Medicare |
$245.61
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$27.13
|
| Rate for Payer: Superior Health Plan EPO |
$245.61
|
| Rate for Payer: Superior Health Plan Medicare |
$245.61
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Universal American Medicare |
$245.61
|
| Rate for Payer: Wellcare Medicare |
$245.61
|
| Rate for Payer: Wellmed Medicare |
$245.61
|
|
|
ED Orthopedic Cast Removal: Arm/Leg
|
Facility
|
IP
|
$644.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
5202579
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$566.72
|
|
|
ED Orthopedic Cast Removal Arm/Leg BCE
|
Facility
|
OP
|
$644.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
5202579
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$354.20
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$57.96
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$57.26
|
| Rate for Payer: BCBS of TX Blue Essentials |
$68.58
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$86.41
|
| Rate for Payer: Cash Price |
$566.72
|
| Rate for Payer: Cash Price |
$566.72
|
| Rate for Payer: Cash Price |
$566.72
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$27.13
|
| Rate for Payer: Cigna Medicare |
$245.61
|
| Rate for Payer: Employer Direct Commercial |
$245.61
|
| Rate for Payer: Humana Medicare/TRICARE |
$245.61
|
| Rate for Payer: Molina CHIP/Medicaid |
$27.13
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$418.60
|
| Rate for Payer: Multiplan Commercial |
$418.60
|
| Rate for Payer: Multiplan Workers Comp |
$418.60
|
| Rate for Payer: Parkland Medicaid |
$27.13
|
| Rate for Payer: Scott and White EPO/PPO |
$4.39
|
| Rate for Payer: Scott and White Medicare |
$245.61
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$27.13
|
| Rate for Payer: Superior Health Plan EPO |
$245.61
|
| Rate for Payer: Superior Health Plan Medicare |
$245.61
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Universal American Medicare |
$245.61
|
| Rate for Payer: Wellcare Medicare |
$245.61
|
| Rate for Payer: Wellmed Medicare |
$245.61
|
|
|
ED Orthopedic Splinting Site
|
Facility
|
OP
|
$488.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
4272028
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$317.20 |
| Rate for Payer: Aetna Commercial |
$268.40
|
| Rate for Payer: Aetna Medicare |
$175.23
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$43.92
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Amerigroup Medicare |
$116.82
|
| Rate for Payer: BCBS of TX Blue Advantage |
$91.87
|
| Rate for Payer: BCBS of TX Blue Essentials |
$110.02
|
| Rate for Payer: BCBS of TX Medicare |
$116.82
|
| Rate for Payer: BCBS of TX PPO |
$138.63
|
| Rate for Payer: Cash Price |
$429.44
|
| Rate for Payer: Cash Price |
$429.44
|
| Rate for Payer: Cash Price |
$429.44
|
| Rate for Payer: Cigna Commercial |
$264.63
|
| Rate for Payer: Cigna Medicare |
$116.82
|
| Rate for Payer: Employer Direct Commercial |
$116.82
|
| Rate for Payer: Humana Medicare/TRICARE |
$116.82
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Molina Medicare |
$116.82
|
| Rate for Payer: Multiplan Auto |
$317.20
|
| Rate for Payer: Multiplan Commercial |
$317.20
|
| Rate for Payer: Multiplan Workers Comp |
$317.20
|
| Rate for Payer: Scott and White EPO/PPO |
$2.09
|
| Rate for Payer: Scott and White Medicare |
$116.82
|
| Rate for Payer: Superior Health Plan EPO |
$116.82
|
| Rate for Payer: Superior Health Plan Medicare |
$116.82
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Universal American Medicare |
$116.82
|
| Rate for Payer: Wellcare Medicare |
$116.82
|
| Rate for Payer: Wellmed Medicare |
$116.82
|
|
|
ED Orthopedic Splinting Site: Finger Splint, static
|
Facility
|
OP
|
$488.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
4272028
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$317.20 |
| Rate for Payer: Aetna Commercial |
$268.40
|
| Rate for Payer: Aetna Medicare |
$175.23
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$43.92
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Amerigroup Medicare |
$116.82
|
| Rate for Payer: BCBS of TX Blue Advantage |
$91.87
|
| Rate for Payer: BCBS of TX Blue Essentials |
$110.02
|
| Rate for Payer: BCBS of TX Medicare |
$116.82
|
| Rate for Payer: BCBS of TX PPO |
$138.63
|
| Rate for Payer: Cash Price |
$429.44
|
| Rate for Payer: Cash Price |
$429.44
|
| Rate for Payer: Cash Price |
$429.44
|
| Rate for Payer: Cigna Commercial |
$264.63
|
| Rate for Payer: Cigna Medicare |
$116.82
|
| Rate for Payer: Employer Direct Commercial |
$116.82
|
| Rate for Payer: Humana Medicare/TRICARE |
$116.82
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Molina Medicare |
$116.82
|
| Rate for Payer: Multiplan Auto |
$317.20
|
| Rate for Payer: Multiplan Commercial |
$317.20
|
| Rate for Payer: Multiplan Workers Comp |
$317.20
|
| Rate for Payer: Scott and White EPO/PPO |
$2.09
|
| Rate for Payer: Scott and White Medicare |
$116.82
|
| Rate for Payer: Superior Health Plan EPO |
$116.82
|
| Rate for Payer: Superior Health Plan Medicare |
$116.82
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Universal American Medicare |
$116.82
|
| Rate for Payer: Wellcare Medicare |
$116.82
|
| Rate for Payer: Wellmed Medicare |
$116.82
|
|
|
ED Orthopedic Splinting Site: Finger Splint, static
|
Facility
|
IP
|
$488.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
4272028
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$429.44
|
|
|
ED Orthopedic Splinting Site Finger Splint, static BCE
|
Facility
|
OP
|
$488.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
4272028
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$317.20 |
| Rate for Payer: Aetna Commercial |
$268.40
|
| Rate for Payer: Aetna Medicare |
$175.23
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$43.92
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Amerigroup Medicare |
$116.82
|
| Rate for Payer: BCBS of TX Blue Advantage |
$91.87
|
| Rate for Payer: BCBS of TX Blue Essentials |
$110.02
|
| Rate for Payer: BCBS of TX Medicare |
$116.82
|
| Rate for Payer: BCBS of TX PPO |
$138.63
|
| Rate for Payer: Cash Price |
$429.44
|
| Rate for Payer: Cash Price |
$429.44
|
| Rate for Payer: Cash Price |
$429.44
|
| Rate for Payer: Cigna Commercial |
$264.63
|
| Rate for Payer: Cigna Medicare |
$116.82
|
| Rate for Payer: Employer Direct Commercial |
$116.82
|
| Rate for Payer: Humana Medicare/TRICARE |
$116.82
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Molina Medicare |
$116.82
|
| Rate for Payer: Multiplan Auto |
$317.20
|
| Rate for Payer: Multiplan Commercial |
$317.20
|
| Rate for Payer: Multiplan Workers Comp |
$317.20
|
| Rate for Payer: Scott and White EPO/PPO |
$2.09
|
| Rate for Payer: Scott and White Medicare |
$116.82
|
| Rate for Payer: Superior Health Plan EPO |
$116.82
|
| Rate for Payer: Superior Health Plan Medicare |
$116.82
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Universal American Medicare |
$116.82
|
| Rate for Payer: Wellcare Medicare |
$116.82
|
| Rate for Payer: Wellmed Medicare |
$116.82
|
|
|
ED Orthopedic Splinting Site: Posterior Long Arm Splint
|
Facility
|
OP
|
$490.00
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
5202580
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$326.44 |
| Rate for Payer: Aetna Commercial |
$269.50
|
| Rate for Payer: Aetna Medicare |
$216.15
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$44.10
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Amerigroup Medicare |
$144.10
|
| Rate for Payer: BCBS of TX Blue Advantage |
$83.17
|
| Rate for Payer: BCBS of TX Blue Essentials |
$99.60
|
| Rate for Payer: BCBS of TX Medicare |
$144.10
|
| Rate for Payer: BCBS of TX PPO |
$125.50
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cigna Commercial |
$326.44
|
| Rate for Payer: Cigna Medicaid |
$40.14
|
| Rate for Payer: Cigna Medicare |
$144.10
|
| Rate for Payer: Employer Direct Commercial |
$144.10
|
| Rate for Payer: Humana Medicare/TRICARE |
$144.10
|
| Rate for Payer: Molina CHIP/Medicaid |
$40.14
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Molina Medicare |
$144.10
|
| Rate for Payer: Multiplan Auto |
$318.50
|
| Rate for Payer: Multiplan Commercial |
$318.50
|
| Rate for Payer: Multiplan Workers Comp |
$318.50
|
| Rate for Payer: Parkland Medicaid |
$40.14
|
| Rate for Payer: Scott and White EPO/PPO |
$2.58
|
| Rate for Payer: Scott and White Medicare |
$144.10
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$40.14
|
| Rate for Payer: Superior Health Plan EPO |
$144.10
|
| Rate for Payer: Superior Health Plan Medicare |
$144.10
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Universal American Medicare |
$144.10
|
| Rate for Payer: Wellcare Medicare |
$144.10
|
| Rate for Payer: Wellmed Medicare |
$144.10
|
|
